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SAN JOAQUIN CUUN I Y Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE � AccountlD I AR0017288 <br /> Facility ID F FA0010288 <br /> Date Printed F 4/28/2011 <br /> MUFFLER MAN (LODI) RE : MUFFLER MAN <br /> <br /> LODI, CA 95240 <br /> OWNER : LOOCK,JIMILOOCK LIVING TRUST <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0211802---Date of invoice: 1/31/2011 ������������������I���IIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111IN111111111111111I111 <br /> 1/28/2011 2244 2011 HAZMAT FEE $ 255.00 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2011 9987 Haz Mat Program Penalty Fee $ 25.50 <br /> w lnvolce $ 329.50 <br /> Payment Due Date 3/212011 <br /> TOTAL DUE this Billing Period $ 329.50 <br /> IRAIRAST DUE <br /> Delinclfent charges <br /> will be forwarded to <br /> in. 30 days, <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For DES/HMMP Fees For all SERVICE FEES _ <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />